Case management

Our case managers help make health care easier and less overwhelming for our members. They work with members to help them understand the types of services we offer and how to participate in their own care.

Your patients may already be working with one of our case managers. If not, or if they need help contacting their case manager, please have them contact  Member Services at 1-855-459-1566.

Our case managers may call our members if:

  • They or you, as their provider, think case management might help the member.
  • They have just gotten out of the hospital and need help with follow-up visits to other doctors.
  • They are going to the emergency room (ER) often for nonurgent care that could be handled by you (their provider).
  • They call our 24-hour Nurse HelpLine and need more follow-up for ongoing care.
  • They have serious physical problems and need more help managing their health.
  • They have behavioral health problems and need more help working with all of their doctors.

Case managers can also help with:

  • Setting up health care services.
  • Getting referrals and prior authorizations.
  • Checking the plan of care.

From time to time, members may have questions about calls they receive from one of our case managers. When we call, a nurse or social worker will:

  • Always identify themselves with their name, title and position with Simply Healthcare Plans, Inc.
  • Tell the member about the services we offer.
  • Talk to the member about their health and how they are handling different parts of their life.

Provider tools & resources

Interested in becoming a provider in the Simply network?

We look forward to working with you to provide quality service for our members.